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Monitoring the Delivery of Personal Care Services: Key Considerations for Health Plans
Health plans increasingly will be required to provide oversight for a broader range of services as more states contract for managed long-term services and supports. These services may include personal care services delivered by direct service workers (DSWs). Monitoring the
[...]Published Date: April 15, 2019 -
Oversight of Transportation Services: Key Considerations for Health Plans
Health plans increasingly will be required to oversee non-emergency transportation services as more states contract for managed long-term services and supports (LTSS). Oversight often refers to preventing fraud and abuse, which requires ensuring that the services being billed are actually
[...]Published Date: April 15, 2019 -
Contracting with Behavioral Health DSWs: Key Considerations for Health Plans
Behavioral health long-term services and supports (LTSS), such as health navigation, peer support, and developmental therapy, assist members in maintaining independence by coordinating resources and care, serving as mentors and personal models of recovery, and integrating appropriate developmental supports. As
[...]Published Date: April 15, 2019 -
Assessing the Capacity of HCBS Providers: Key Considerations for Health Plans
Home and community-based services (HCBS) encompass a broad range of services and supports designed to help older adults and people with disabilities live in their homes and communities rather than in institutional settings. If your health plan operates in states
[...]Published Date: April 15, 2019 -
Contracting with Health Plans: Key Considerations for Behavioral Health-Focused LTSS Providers
Many states are implementing managed long-term services and supports (LTSS) for their Medicaid populations, including those experiencing mental illness, addiction, or intellectual and developmental disabilities. For this reason, health plans in your area may be seeking providers who can deliver
[...]Published Date: April 15, 2019 -
Identifying & Engaging Behavioral Health-Focused LTSS Providers: Considerations for Health Plans
As your health plan becomes engaged with persons eligible for both Medicare and Medicaid – particularly those with behavioral health needs, developmental disabilities, or substance abuse challenges – you may find it necessary to provide behavioral health long-term services and
[...]Published Date: April 15, 2019 -
Long-Term Services & Supports – Calvin’s Story
Long-term services and supports (LTSS) comprise the range of home and community-based services and supports that allow participants to reside in their home and engage in their community. In the context of disability-competent care, planning LTSS involves identifying functional needs
[...]Published Date: April 12, 2019 -
Key Contract Components: Considerations For Providers
More states are contracting with health plans to manage Medicaid long-term services and supports (LTSS). As a result, you may find yourself working with health plans instead of the state to provide care for your Medicaid clients. Contracting with a
[...]Published Date: April 10, 2019 -
Contracting With Health Plans: Key Considerations For Providers
Many states are implementing managed long-term services and supports (LTSS) to better coordinate care for Medicaid recipients. This may change the way your organization provides Medicaid services by requiring you to contract or enter into an agreement with one or
[...]Published Date: April 10, 2019 -
Care Coordination – Sam and Deb’s Story
A person-centered approach is key in disability-competent care coordination. Care coordinators help participants with disabilities and chronic health conditions manage risk within the context of their personal preferences as well as their health and safety needs. Sam and Deb’s story
[...]Published Date: April 10, 2019